The province currently has more than 647,550 people covered by health insurance. Of these, 633,989 are enrolled within the province, while 13,563 hold health insurance cards issued by other provinces or the Ministry of Public Security. The provincial health insurance coverage rate has reached 95.56%.

With the implementation of the revised Health Insurance Law, Decree No. 188/2025/ND-CP, and Decree No. 161/2026/ND-CP, all effective from July 1, 2026, residents are entitled to a range of enhanced benefits designed to improve access to healthcare services while easing the financial burden associated with illness.

One of the most significant changes is the adjustment of reimbursement thresholds based on the new statutory base salary of VND 2.53 million per month.

Under the new regulations, patients whose medical expenses for a single visit are less than 15% of the base salary, equivalent to under VND 379,500, will receive 100% reimbursement from the health insurance fund. Previously, full reimbursement applied only to medical bills below VND 351,000.

Participants who have maintained continuous health insurance coverage for five years or more will also be entitled to full reimbursement within the benefit package once their annual co-payment exceeds six times the base salary, or VND 15.18 million, compared with the previous threshold of VND 14.04 million.

The policy also raises reimbursement limits for certain medical technical services. When insured patients are prescribed eligible technical procedures, the health insurance fund will cover the cost of medical equipment used during the procedure up to 45 months of the base salary, equivalent to VND 113.85 million, compared with the previous ceiling of VND 105.3 million.

Another important change is the expansion of insurance coverage for selected outpatient services provided at primary-level and specialized healthcare facilities, making healthcare more accessible to the public.

Specifically, patients receiving outpatient treatment at primary-level or specialized medical facilities will be reimbursed 50% of their entitled benefit level for diseases and medical conditions not included in the list specified under Circular No. 01/2025/TT-BYT.

These changes are expected to significantly reduce out-of-pocket medical expenses, particularly for patients suffering from chronic illnesses, those requiring long-term treatment, and disadvantaged groups.

Lò Thị Mây, a resident of Tuần Giáo commune, welcomed the new policy. “There are elderly members in my family who need regular medical check-ups. We are very pleased to learn that the new policy increases both benefit levels and reimbursement rates. Having health insurance helps us save considerably on treatment costs and gives us greater peace of mind whenever illness occurs,” she said.

Trần Sơn, Director of the Điện Biên provincial Social Security Agency, said the revised policy substantially expands insurance benefits and makes healthcare services more accessible to the public.

To ensure effective implementation, the provincial agency has introduced a range of coordinated measures. It is working closely with the health sector and medical institutions to communicate the new regulations, helping residents better understand their rights and obligations while ensuring an adequate supply of medicines, medical supplies and equipment for patient care.

The agency has also strengthened health insurance assessment and expanded the use of digital technologies to monitor medical expenditures, ensuring that the insurance fund is managed safely, efficiently, transparently and economically while preventing fraud and abuse. Electronic records and cost management software have been deployed to shorten administrative processing times and better protect participants’ legitimate rights.

The provincial Social Security Agency regularly organizes training sessions for healthcare professionals on the new regulations, professional procedures and insurance payment mechanisms to ensure consistent implementation.

At the same time, it continues to inspect and evaluate policy implementation at healthcare facilities, promptly recommending solutions where necessary while maintaining channels for receiving and addressing public feedback to improve service quality and participant satisfaction.

The agency is also strengthening the capacity of its social and health insurance collection staff to expand outreach across communes, wards, villages and residential communities, making it easier for residents to participate in the insurance system.

In addition, communication campaigns are being intensified through mass media and social media platforms. Community-based consultation meetings and direct dialogue sessions are held regularly in villages, while monthly outreach campaigns introduce social and health insurance policies to local residents. Citizens are also encouraged to use the VssID mobile application to track their participation history and access information on their insurance benefits.